Use Univita as lightning rod for action

Friday, September 25, 2015

This is exactly the situation that we said would happen with this type of model that limits providers and limits access to care (“Chaos erupts as Univita loses biz,” September 2015 ).

We need to get this story out to Congress and to state Medicaids across the country. Our words mean nothing to them; however, the result of this bankruptcy should resonate loud and clear that the train needs to stop rolling down the track because the only light at the end of the tunnel is the train!

We need to let consumers know that this will happen to their care if they don’t get involved. They need to shout that they are not going to let their benefits continue to erode right in front of them by preventing quality providers into these networks. 

The only way you get quality is through competition and when you limit competition you limit care. 

The model of limited providers and limited reimbursement will never be able to sustain the exponential growth of the baby boomers. We need to make this front page news everywhere!

This is exactly what we needed to happen; however, unfortunately, it’s at the cost of the providers who will never get paid for the services and equipment rendered and the patients who are being held hostage by their state Medicaids for allowing this to happen.

Let’s not let this opportunity pass us by; let’s use this as our springboard to get their attention on the real issue that they have created. 

I can’t even begin to image what is going to happen to the rural areas when they get hit with reimbursement cuts and to the patients who won’t have providers to care for them.

What immediate action steps can we take to get this story in front of our legislators, managed care companies and the consumers? We must act quickly!

— Tammy Zelenko, AdvaCare Home Services

Who’s really to blame for Univita’s collapse?

I am reading the Univita story in the latest edition and something is missing or was lost in translation.

Univita did not contract with AHCA (Agency for Healthcare Administration) who oversees the Statewide Medicaid Managed Care (SMMC)—Managed Medical Assistance Program (MMA). Univita contracted with the various standard managed healthcare plans. I do not know if all the plans were using Univita, but many were.

It is easy for us to point the finger at AHCA, however, it was the health plans who were trying to save money on DME. Many of the plans are large providers who have DME contracts for Medicare Advantage and similar plans. They know what DME costs. It is the healthcare plans that signed the DME contracts with Univita, not AHCA.

It would seem reasonable that AHCA has some sort of contractual performance requirements for the healthcare plans. Given that assumption, shouldn’t the industry be watching to see what AHCA’s direction is regarding the affected healthcare plans noncompliance or nonperformance of contract?

Univita is history; we should be looking forward to see if the managed care plans will have adequate reimbursement levels to provide the DME services mandated by AHCA. Florida Medicaid has many provision of service requirements exceeding Medicare. The healthcare plans need to take this into consideration, too.

— Bob Lichtenstein, Hollywood Medical Supply